Title Promoter Affiliations Abstract "BelRAI Rehabilitation: evaluation of interRAI rehabilitation instruments for use in rehabilitation in Flanders" "Anja Declercq" "LUCAS - Centre for Care Research and Consultancy" "There is a strong link between BelRAI and the International Classification of Functioning (ICF). Together with Ghent University, LUCAS developed a BelRAI instrument that also operationalizes ICF for adults in rehabilitation care in Flanders.We test: (1) content validity, (2) the extent to which the instrument represents the bio-psycho-social ICF model, and (3) the conditions for implementation of the instrument." "Efficacy of evidence-based audiological rehabilitation: Leuven Interactive Scheme for hearing Training Evaluation and audiological rehabilitatioN (LISTEN)" "Astrid van Wieringen" "Research Group Experimental Oto-rhino-laryngology" "The primary goal of LISTEN is to optimize the communication of adults and children affected by different degrees of Hearing Impairment (HI) by means of a sustainable and personalized scheme for audiological rehabilitation on a tablet computer. LISTEN comprises several tests, questionnaires and auditory training tasks, as well as additional features such as an acoustic environment classifier and tailored recommendations for the user. The doctoral research consists in the development of an open, cost-effective e-health platform for audiological rehabilitation, available to patients free of charge, easily extensible for researchers and clinicians and that administers automatically a personalized scheme for audiological rehabilitation. It is necessary to conduct in-depth research to determine the most optimal scheme for audiological rehabilitation (dependent on age, degree of HI). The research also consist of clearly defining the criteria for effectiveness (functional gain), dependent on the degree of HI. These criteria will then be evaluated during multiple clinical trials. " "Rehabilitation nurse and occupational therapist: a tandem in multidisciplinary rehabilitation" "Annick Van Gils" "Health and science" "Abstract is not available in english" "Impact of an intensive rehabilitation programme integrating advanced rehabilitation technology for adults in the chronic phase after a stroke: A randomised controlled trial." "Geert Verheyden" "Research Group for Neurorehabilitation (eNRGy)" "The doctoral research consists of a four-year project. The overall aim of this project is to gain knowledge about the effectiveness of an intensive rehabilitation programme using advanced technology in adults with neurological disorders in the chronic phase. This project consists of data collection and analysis of a pilot study (1) and a large phase III randomised controlled trial (2).(1) The pilot study was conducted in 2022 and had a pre-post intervention design, recruiting 20 patients in the chronic phase after stroke. Error-enhancement treatment was provided one hour per day for 5 consecutive days and consisted of facilitation of accuracy, range of movement, stability, and smoothness with the DeXtreme device. Two times 20 min. of DeXtreme training was alternated with 15 min. conventional therapy, stretching and (auto-) mobilization. Advancements in upper limb motor function and activity were evaluated through a triad of measurements including clinical and patient-reported outcomes, error-enhancement variables, and objective quantification of uni- and bimanual sensorimotor function by making use of the KINARM robotic manipulandum. The recruitment ended in November 2022. Within this PhD project, I have already conducted data analysis and am currently writing the manuscript of this pilot study.Research Question: Have patients with upper limb impairments in the chronic phase after stroke clinical and meaningful benefits and improved quality of movement after 5 hours of error-enhancement robot-based reaching training? (2) The single-blined randomized controlled trial will consist of with 3 main components: (A) Clinical; (B) Health economic; and (C) Process evaluation. The programme, designed for patients with upper and/or lower limb disorders in the chronic phase after stroke or spinal cord injury, is based on the patient's goals and needs and includes the use of advanced rehabilitation technology and a self-management programme. There will be 100 patients in the chronic phase after stroke or spinal cord injury participating in the study. The study will consist of 3 measurement moments: baseline, after 3 weeks, and after 9 months. At these moments, both tests and questionnaires will be administered on upper and/or lower limb function, independence in daily life, quality of life, fatigue, self-management and health and economic data. The intervention group starts with 3 weeks of intensive therapy (90 hours spread over 3 weeks), a combination of standard therapy and technological devices, and is then followed up to 9 months. The therapy will take place in AZ Herentals. The control group is allowed to continue its standard therapy for 9 months. After the end of the study, they will also be given the opportunity to follow this intensive 3-week rehabilitation. During the follow-up period, quality of life, therapy diary (content, frequency, duration of standard therapy) and health economic data are surveyed monthly.Research Question:(A) Do patients with upper and/or lower limb deficits in the chronic phase after stroke or spinal cord injury have clinical and meaningful benefits after 90 hours of intensive personalized rehabilitation programme using advanced rehabilitation technology, compared to usual care?(B) Is an intensive personalized rehabilitation programme using advanced rehabilitation technology cost-effective compared to usual care in chronic stroke or spinal cord injury?(C) What are the facilitators and barriers in implementing the new intensive programme into clinical practice and embedding this in health care policy?" "Rehabilitation nurse and occupational therapist: a tandem in multidisciplinary rehabilitation" "Annick Van Gils" "AP Hogeschool Antwerpen, Health and science" "Abstract is not available in english" "Global WHO Rehabilitation Action Plan 2030: Clinical guidelines, mapping Rehabilitation services in Health Systems, Health economy, Competence frameworks" "Peter FEYS" "Rehabilitation Research Center" "On 17/11/2017 the Research Council has approved the short stay at World Health Organisation, departement 'Non-communicable diseases, disability, violence and injury', Zwitserland, chargeable to the BOF-program 'Short Stays - outgoing mobility'. The stay will take place in 2018." "Gait rehabilitation needs a hand: the inclusion of arm movements in gait rehabilitation training for patients with Cerebral Palsy." "Kaat Desloovere" "Research Group for Neurorehabilitation (eNRGy), Movement Control & Neuroplasticity Research Group" "We will investigate whether children with unilateral Cerebral Palsy (CP) are able to intentionally increase arm swing on the hemiplegic side and if there are non-invasive ways to optimize the increase of the swing amplitude by providing auditory feedback. Of particular interest is the effect of this short term training on the gait pattern. Secondly we will evaluate the integrity of brain white matter connections in order to find the neural correlates of the pathological arm swing during gait in CP. An early study did reveal that the location and size of the brain lesion correlates with the severity of hand function deficits (e.g. reaching and grasping) in children with unilateral CP. However, it is unknown whether this pertains also to arm swing in a locomotor context. Moreover, we will test whether the degree of microstructural integrity of these pathways is predictive of gait recovery after arm swing manipulation. This would allow us to pre-select the subset of CP children that would benefit most from the inclusion of arm swing training for future rehabilitation programs, based on the quality of their anatomical connections. For example, it might not be possible to normalize the arm swing in children in which the corticospinal tract is severely damaged." "Towards a shared data repository to enhance the standards of rehabilitation in MS: feasibility, capacity building and proof-of-concept on exercise therapy & mobility measures" "Peter FEYS" "Rehabilitation Research Center" "Persons with progressive MS show overall more disability than those with relapsing remitting type of MS. Exercise therapy is a potentially effective treatment modality. However, despite an explosion of research on physical rehabilitation and exercise, it is not yet clear whether beneficial effects are equally present in progressive compared to relapsing-remitting type of MS, and to what degree effects are dependent on severity level and the intervention (modality , duration and intensity). Also, it is not well-known which outcome measures are the best to measure changes in mobility that are meaningful to the person with MS. The development of this knowledge, specifically on exercise but also generally on rehabilitation, has been delayed in part by four issues: 1) small sample sizes that do not allow distinction of effects according to MS type or disability level, 2) limited systematic description of the intervention content (so-called 'black box' of rehabilitation), 3) inconsistent inclusion of multi-dimensional outcome measures with insufficient knowledge on their accuracy and values of meaningful change and 4) limited efforts to determine the dosage-response of different rehabilitation strategies. The long-term goal is to provide answers to research questions on the multi-dimensional effects of rehabilitation according to type of MS, disability level as well as intervention content. This project concerns preparing the construction of a large shared data repository that will be established by 1) retrospective data retrieval of individual patient data of published studies and 2) prospective data entry by clinical and research centers by means of a rehabilitation registry. This will allow researchers to investigate questions on the (comparative) effects of specific interventions and settings, or on the appropriateness of different outcome measures. Ultimately, this will lead to improved standards in MS rehabilitation practice. Rehabilitation may be an effective treatment to maintain physical function in progressive MS patients. In contrast to medical registries, a rehabilitation repository does not exist. It is needed to allow the investigation of research questions in large samples of persons with multiple sclerosis, which will ultimately advance the scientific certainty and impact of exercise/rehabilitation studies in MS. This 1-year start-up grant will allow us to investigate 1) the legal regulation of repositories in Europe and the United States , 2) practice examples of existing registries, 3) researcher's perceived barriers and facilitators to data sharing, 4) clinician's willingness and ability to provide data in a registry, 5) engagement of experts to collaborate in workgroups to define the outcome measures for the registry, and opinion on classification systems for treatment. Proof-of-concept studies will be performed in the domain of exercise therapy and mobility outcome measures. Consultation of researchers and clinicians will take place during conferences of supportive international rehabilitation organizations. A platform will be established for information and communication. The project may provide information on effectiveness of exercise therapy in patients with progressive MS within 1 year. In a longer perspective, it may lead to detailed evidence-based guidelines on physical rehabilitation followed by also other domains as upper limb function, speech therapy and cognitive rehabilitation." "Juvenile delinquency and rehabilitation: Examining the Good Lives Model" "Corine de Ruiter, Stefaan Pleysier" "Leuven Institute of Criminology, Institute for Social Law" "Juvenile justice systems in a number of Western societies oftentimes apply a rehabilitation model known as the ‘Risk Need Responsivity’ (RNR) model. Offender rehabilitation interventions based on the RNR model focus heavily on eliminating empirically derived dynamic risk factors that are directly linked to delinquency and recidivism (i.e., criminogenic risk factors). However, a large proportion of young offenders placed in residential juvenile justice settings, are also diagnosed with psychiatric disorders (prevalence rates varying between 50% and 90%). Common diagnoses include attention deficit hyperactivity disorder (ADHD) and conduct disorder, but (comorbid) depression and anxiety disorders are prevalent as well. Additionally, having experienced childhood maltreatment or other traumas are also common. Both mental health problems and trauma have not only been related to an increased recidivism risk, but also to a decreased quality of life and well-being in adolescents, especially for those in residential settings. This poses a challenge for the juvenile justice system as it creates a tension between the need to care for and treat ‘patients’ (a welfare-focused approach) and the need to reduce risk and protect society from ‘offenders/recidivists’ (a risk-focused approach).                                                                                                                     An upcoming theoretical framework, the ‘Good Lives Model of offender rehabilitation’ (GLM), could potentially overcome this tension. The GLM suggests that effective rehabilitation interventions should adopt a dual focus: both reducing recidivism risk and enhancing the offender’s well-being, by prosocially meeting a universal set of human needs called ‘primary goods’. A focus on primary goods attainment and well-being is believed to reduce the risk of recidivism more sustainably by promising a happier and prosocial life, rather than merely a less risky one. Moreover, not only working on risk factors (determined by professionals), but also on personally relevant needs and well-being, is thought to contribute to higher levels of treatment motivation and (subsequently) enhance recidivism (risk) reduction. Although these ideas are promising, clear evidence for the underlying assumptions of the GLM is still lacking, especially in adolescents.                                                                              Consequently, in this dissertation, we examined the underlying assumptions of the GLM about the explanation of criminal behavior from the associations between primary goods, psychopathology, and well-being in adolescents. In addition, we examined whether satisfaction with primary good attainment, and changes therein, in detained adolescent delinquents are related to their well-being, treatment motivation, and recidivism risk over time. To this end, we used a mixed method approach in a sample of adolescents from the general population and a sample of detained adolescent offenders. The hypotheses regarding the role of primary goods and well-being in explaining juvenile delinquency, were empirically tested based on survey data of a large sample of adolescents residing in the community (N = 4,260) in Flanders, Belgium. Additionally, we conducted a quantitative (N = 170) and qualitative study (n = 31) with recently arrested and detained male adolescent offenders regarding their primary goods satisfaction, well-being, mental health problems, criminogenic risk (factors), and committed offense(s). These studies were conducted in two juvenile detention centers: one in Flanders, Belgium and one in the Netherlands. In a third study, we examined the longitudinal associations between (changes in) primary goods satisfaction, overall well-being, mental health problems, treatment motivation, and recidivism risk, based on the follow-up data of detained adolescents (n = 62), who were followed during their residential stay in the juvenile detention centers.                                                                                                                                           Taken together, our findings support the idea that adding a strengths-based approach such as the GLM to the RNR model could indeed bridge the gap between the risk-focused approach and the welfare-focused approach in juvenile justice. The findings provide initial evidence that promoting well-being can lower the recidivism risk of young offenders. Moreover, they suggest that working on ‘non-criminogenic’ factors, such as mental health problems and primary goods satisfaction, may improve juvenile offender rehabilitation. " "Uncovering short- and long-term circuit mechanisms of locomotor rehabilitation after spinal cord injury." "Aya Takeoka" "Laboratory for Circuit Neuroscience" "Severe spinal injuries disrupt communication between the brain and circuits below the lesion. Therapeutic approaches aim for functional recovery by facilitating axonal growth, removing growth barriers, or replacing lost cells. However, all approaches face a common challenge: the spinal cord below the injury must adapt to function with limited brain input. Rehabilitative training facilitates locomotor recovery by “teaching” the spinal cord to generate movements under such conditions. Nevertheless, we know little about the identities of spinal neurons and mechanisms contributing to locomotor recovery.My lab has identified a mechanism in which repetitive training promotes excitability of the spinal cord over weeks to months via defined classes of neurons. Our data suggest the exciting possibility that training-induced improvements are driven by specific cell types. However, how spinal neurons are modulated in a short timescale remains unclear, i.e., within a training session, which leads to beneficial outcomes of long-term training. Here, we leverage a unique approach of recording neuronal activities in awake, behaving mice to understand how defined neurons facilitate locomotor improvements during a single training session. We will link this short-term adaptation to long-term change by screening the diversity of neurons activated at different rehabilitative training stages. This work will contribute to future developments in facilitating recovery after spinal cord injury."